DR. GAWTHAM GUTTA (NPI# 1245262617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245262617 |
| Entity Type | Individual |
| Full Name | DR. GAWTHAM GUTTA |
| Credential | M.D. |
| Practice Address |
2100 Glenwood Ave Joliet IL 60435-5487 |
| Mailing Address |
1860 Paysphere Cir Chicago IL 60674-0018 |
| Practice Telephone | 8157252121 |
| Practice Fax Number | 8157416314 |
| Mailing Telephone | 6304699200 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2019-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
036111915 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | TAX ID | 200671848 | 01 |
| IL | AETNA | 7833585 | 01 |
| IL | CIGNA | 4434036 | 01 |
| IL | 036111915 | 05 |
| Street Address |
2100 GLENWOOD AVE |
| City | JOLIET |
| State | IL |
| Zip Code | 60435-5487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689675811 | Timothy Fendon | Emergency Medicine | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2005-08-10 |
| 1396371811 | Leonard Kevyn Banogon Ferolin | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2020-03-16 |
| 1093370611 | Kyle Ren Barcenas Fernando | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2019-05-08 |
| 1376034918 | Kathryn Schroeder | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2018-05-18 |
| 1033609763 | Matthew Peter Lukanich | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2018-05-17 |
| 1588151260 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2018-04-18 |
| 1790284487 | Daniel Capparelli | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2018-02-08 |
| 1831616044 | Michael John Donovitch | Physical Therapist | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2017-08-28 |
| 1700309895 | Michael Plachy Jr. | Physical Therapy Assistant | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2017-07-20 |
| 1487189551 | Alyssa Brown | Occupational Therapist | 2100 Glenwood Ave, Suite 110, Joliet, IL 60435-5487 | 2017-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851889018 | Chime Ajiere | Nurse Practitioner | 511 Theodore St, Joliet, IL 60435 | 2018-04-24 |
| 1740791284 | Melanie Presnak | Speech-Language Pathologist | 1207 N Larkin Ave, Joliet, IL 60435 | 2017-10-23 |
| 1831618883 | Jeriel Marsena Quarles | Licensed Practical Nurse | 1617 W Jefferson Street, Joliet, IL 60435 | 2017-09-11 |
| 1053769760 | Cody Hutchinson | Physical Therapy Assistant | 2943 W Jefferson St, Joliet, IL 60435 | 2016-06-03 |
| 1659748549 | Megan Ryab | Massage Therapist | 501 Wilcox St, Joliet, IL 60435 | 2015-08-26 |
| 1922416197 | Kodo Care, Inc. | Pharmacy | 221 Springfield Avenue, Suite A, Joliet, IL 60435 | 2014-07-31 |
| 1528489739 | My Family Doc LLC | Family Medicine | 2001-03 Essington Rd, Joliet, IL 60435 | 2013-12-16 |
| 1184973869 | R A Lombardi Dds PC | Dentist | 3011 Theodore St., Joliet, IL 60435 | 2012-09-10 |
| 1245546076 | Kelly Rae Lesemann | Chiropractor | 1011 Essington Road, Joliet, IL 60435 | 2010-08-31 |
| 1932413697 | Ann E Todd | Optometrist | 1521 Essington Road, Everything In Sight, Joliet, IL 60435 | 2010-08-04 |
| Find all providers in zip 60435 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659300796 | Abhin Singla | Internal Medicine | 801 N Larkin Ave Ste 101, Joliet, IL 60435 | 2006-07-01 |
| 1487798955 | Clinical Associates In Medicine, LLC | Internal Medicine | 801 N Larkin Ave Ste 101, Joliet, IL 60435 | 2007-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033343132 | Richard Joseph Wallyn | Internal Medicine | 1300 Brassie Ave., Flossmoor, IL 60422-1812 | 2009-05-05 |
| 1477752160 | Arthur Hoffman | Internal Medicine | 2652 Broadway Ave, Evanston, IL 60201 | 2007-07-13 |
| 1841238979 | Mysore N Shivaram | Internal Medicine | 6901 Cermak Rd, Berwyn, IL 60402-2160 | 2006-06-02 |
| 1659342665 | Albert C Tanlim | Internal Medicine | 845 S 4th St, Roberts Clinic Ltd, Watseka, IL 60970-1628 | 2006-01-28 |
| 1184189672 | Calumet Counseling and Dui Services,inc | Internal Medicine | 1010 W 95th St, Chicago, IL 60643-1522 | 2019-02-08 |
| 1407395346 | Bhs Physician Services of Illinois PC | Internal Medicine | 1237 E 1600 North Rd, Gilman, IL 60938-6112 | 2017-02-13 |
| 1588929525 | Opioid Addiction Recovery Services PC | Internal Medicine | 755 S Milwaukee Ave, Suite 210, Libertyville, IL 60048-3253 | 2012-07-05 |
| 1376819565 | Sahar Eftekhar | Internal Medicine | 1 E Superior St Ste 306, Chicago, IL 60611-2595 | 2012-04-01 |
| 1942585468 | Ngu Md. Wellness Ltd. | Internal Medicine | 400 E Randolph St, Apt 2711, Chicago, IL 60601-7329 | 2011-10-15 |
| 1184934036 | Mary S Wenzel | Internal Medicine | 3730 N Lake Shore Dr, Chicago, IL 60613-4236 | 2010-10-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.